Septic Arthritis

Septic arthritis is an infectious inflammation of a joint. It usually presents as acute, progressive pain that increases with motion and eventually leads to the inability to bear weight. The most common presenting features include joint pain, swelling, and fever. Pediatric cases are often associated with bacteremia. Gonococcal arthritis is migratory and associated with dermatitis and tenosynovitis. Optimal positioning of the joint to avoid future contractures is essential, and joint aspiration should be done as soon as possible. IV antibiotics should be given only after aspiration unless the patient is septic, in which case antibiotics should not be delayed. Orthopedic consultation is mandatory in cases of septic arthritis. In documented gonococcal arthritis with no suspicion for other concomitant infection, nonsurgical treatment may be considered if there is complete symptom resolution with IV antibiotics and joint aspiration.